Meditation, other tools help deal with stresses of practice


Clay J. Cockerell, MD

The world that physicians knew back in medical school has changed greatly with the implementation of health system reform, the development of new practice models, and evolving reimbursement challenges. As a result, many physicians are stressed, and many more are downright unhappy with their careers.

Dealing with these major career challenges was the focus of an unusual education session, “Lessons for Dermatology From the Tao Te Ching,” on July 28. Tao Te Ching is a spiritual text of 81 messages developed in China about 600 B.C. They can help you be more effective in many aspects of life, said Clay J. Cockerell, MD, course director, who discussed the goals of the session.

“There are 15 pressures doctors face today that are really very important,” said Dr. Cockerell, clinical professor of dermatology and pathology at the University of Texas Southwestern Medical Center, Dallas. “There the things we all hear about, things like integrating EHRs into our practices, MACRA, ICD-10, malpractice suits, and all the various things that we’re faced with.

“A lot of doctors are just getting more and more burned out, and I was seeing that with my colleagues.”

The 15 pressures were listed in a 2015 article in Medical Economics. Dr. Cockerell said other causes of stress and unhappiness for physicians include the behavior of colleagues, patient and societal expectations of perfection versus appreciation of excellence, large corporations and hospitals buying practices and altering them, and fewer physicians joining private practices.

More traditional methods of combating these pressures include:

  • Remembering that medicine is still a noble profession that allows physicians to make a difference in people’s lives
  • Developing an approach to reconnect with what is noble about medicine, and dermatology in particular
  • Understanding the natural law that there is a direct relationship between the amount of service physicians provide to the degree of success and impact they have on others

As he reflected on the increasing pressures and options to deal with them, Dr. Cockerell revisited the text from Tao Te Ching, which he first discovered about 35 years ago.

“I was really moved by the translation of Tao Te Ching,” he said of The Way of Life According to Laotzu, translated by Winter Bynner. “The things it had in there were really universal truths, if you will. If you live your life according to these sort of verses, it could help you.”

Other tools available to help deal with the stresses include:

  • The books and audio and video programs of Wayne Dyer, a philosopher and self-help author
  • The AMA’s Steps Forward program
  • Meditating, especially “loving-kindness” meditation that can be seen at
  • Practicing gratitude and self-compassion; Robert Emmons, PhD, and Kristin Neff, PhD, have written books about gratitude
  • Being a giving individual

“The idea is just to acknowledge that you know there is a lot of negative stuff out there, and it’s so easy to get caught up in negative things,” Dr. Cockerell said. “We have to figure out a way to tune into the good stuff.

“Overall, people still love their own doctors and people still view doctors and medicine as a noble profession. That’s the idea behind what we’re trying to do here — to give people some tools to deal with all these stresses they are coming under.”

Presenting the course with Dr. Cockerell was Steven Kenneth Shama, MD, MPH.

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